title: Positron emission tomography-computed tomography has a clinical impact for patients with cervical cancer.
abstract: BACKGROUND
  Many studies have found that positron emission tomography-computed tomography (PET-CT) has a high sensitivity and specificity in the identification of metastasis in cervical cancer. Herlev Hospital, Denmark, has been performing PET-CTs in stage I-IV cervical cancer since 1 May 2006. The present study investigates the positive (PPV) and negative predictive value (NPV) of PET-CT in stage I disease and the clinical impact of the scan results in all disease stages.
  
  
  METHODS
  In this retrospective study, 83 consecutive patients with cervical cancer were included between 1 May 2006 and 1 November 2007. Data were collected from patient records and PET-CT reports.
  
  
  RESULTS
  Among 47 stage I patients, four had PET-positive findings on the scan in addition to cervical cancer. Only one was a true positive finding. Pelvic lymphadenectomy was performed in 36 stage Ia2-Ib1 patients. Histology from stage I patients revealed a PPV of 25% and a NPV of 88%. Among a total of 36 stage II-IV patients, 14 had PET-positive findings. Five patients had a biopsy performed. Three of these patients were true positives and two were true negatives. Taking of biopsies in the remaining patients was clinically irrelevant. Five patients (6%), all in stage ≥ IIb, were offered an alternative treatment owing to the additional information obtained from the PET-CT.
  
  
  CONCLUSIONS
  PET-CT is useful in the identification of metastatic disease in cervical cancer and it may assist optimal treatment planning; especially in International Federation of Gynecologists & Obstetricians (FIGO) stage > I cancers. Histological verification of PET-positive findings is necessary. The clinical value of PET-CT in early stage cervical cancer may be questioned.
authors.affiliation: Department of Surgery, Glostrup Hospital. rikke_mulvad@hotmail.com
authors.forename: Rikke Mulvad
authors.initials: RM
authors.lastname: Sandvik
authors.forename: Pernille Tine
authors.initials: PT
authors.lastname: Jensen
authors.forename: Helle W
authors.initials: HW
authors.lastname: Hendel
authors.forename: Connie
authors.initials: C
authors.lastname: Palle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging*; D009367:Neoplasm Staging / Q000379:methods; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology